1979, 12-14 Permit: 79-9084 Water SoftenerPLAN NUMBER APPLICATION/ PERMIT —�-- P I
PERMIT NUMBER �
SPOKANE COUNTY — BUILDING CODES DEPARTMENT--r171�i`(l
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 DATE
JOB ADDRESS
1.
LOT I BLOC
2.
OWNER
3.
9
DESIGNER
5. ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
1 III 1 1 Oven _ _ _ LEGAL DESCRIPTION — SEE ATTACHED
CHANGE OF USE FROM TO
6.
PHONE
ZIP
PHONE
ZIP
qq
PH
ZIP
I YPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
% OF 11 OTHER
WORK ❑ BLD. ❑ PLMB. ElMECH: ❑ M.H. ❑ POOL
DESCRIBE WOR
8.
equired Set Backs in Feet
Source
of
utilities
orth South
East West
ize of Parcel
Zone Classification
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
Type Con;q
Occupancy
Sprinklered
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
❑Yes [--]No ❑ Req'd.
'aluation
Building Area in Sq. Ft.
Plumbing
DATE SIGNATURE _
OWL Area
Basement Area
Garage Area
Storage
Plan Check
Env. Health
Split Entry
Split Level
Rancher
Mobile Home
Fire Marshall
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
Req'd.
I Recd.
Not Req'd.
of EXEMPTION
FEES COLLECTED
VALUATION
9.
Source
of
utilities
S
ELECTRIC
WATER
SEWER
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
Plumbing
DATE SIGNATURE _
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
Plan Check
Env. Health
SEPA
Planning
Mobile Home
Fire Marshall
Co. Engineer
Other (Specify)
Utilities TOTAL $
Zone Clearance
WHEN MACHINE VALIDATED IN
SEPA Checklist THIS BECOMES A PERMIT.
I
(!
DATE OFFICIAL i L ti.l� L" —�
03* *3.00
* 0
*3,00,;
17-
i�
908.3
12-14-79
6,479.
SPACE,
.i
U. 4